Women, men, and children may experience bladder dysfunction for a variety of reasons. Most commonly, patients are referred to physical therapy for urinary leakage, urinary urgency/frequency, or incomplete voiding caused by:
- Stress incontinence - the involuntary loss of urine with physical exertion including, coughing, sneezing, getting up from a chair, laughing, or exercising.
- Urge incontinence - the loss of urine that occurs with a strong desire to urinate, but an inability to get to the bathroom in time.
- Mixed incontinence - a combination of stress and urge incontinence.
- Incomplete voiding - a small amount of urine remaining in the bladder after voiding is normal, but a "high post void residual" indicates that the bladder is not emptying as fully as it should.
Therapy is recommended to strengthen pelvic-floor and lower-abdominal muscles, train these muscles to work together in a coordinated manner, or re-educate the pelvic floor muscles to relax as the bladder contracts.
Treatment may include individualized and accurate exercise (40 percent of women do Kegel exercises incorrectly), and electrical stimulation to ease bladder urgency and increase muscle tone, and biofeedback and bladder training.